MS-2014-02113_0001.tif CITYOF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
AIM = Building Permit Application (402) 426 -4191 -Phone
(402) 426 -4195 - FAX
MS -2014 -02113
Ise °t a`' www.blairnebraska.org
08/12/2014 1 MISC Residential August 12, 2014
LOCATIONOFIMPROVEMENT: 1517 South St, Blair, NE 68008
ARCHITECT:
f GENERAL Benne Builders Inc
a . OWNER: Dale D And Eldora A Gentzler CONTRACTOR:
1696 Co Rd P41
1517 South St OMAHA, NE 68122
BLAIR, NE 68008 -0000
NATURE OF WORK STRUCTURE
Storm Repair Primary Residence
PROJECT NAME PERMIT EXPIRES 08/11/2016
1517SouthSt- 140812 -2014 Storm Damage
ESTIMATED COMPLETION DATE 12/31/2014
DESCRIPTION OF WORK
Roof, siding, windows
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck/COMcheck SUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
1. No work will be started before a permit is ISSUED AND POSTED.
2. For commercial permits, a set of plans for this project must be submitted to the Nebraska State Fire Marshal's Office for review.
3. Separate permits are required for electrical, plumbing, heating, ventilating and air conditioning, and septic system.
4. The undersigned owner or agent understands and acknowledges this building permit application does not constitute issuance of
this building permit. It is further understood that construction covered by this permit application shall not be commenced until a
copy of a permit signed by the Building Inspector is issued.
5. The undersigned owner or agent agrees to perform the proposed work in accordance with the specifications set forth above and
in accordance with the codes /ordinances of the City of Blair and the State of Nebraska. Any omission of or misrepresentation of
fact with or without ' ention of the undersigned or any alteration or change from this application without approval of the
Building O ic;lal, shall o itute sufficient ground for the revocation of any permit issued which was based on the appr val of this
appli oP. P -
Signature of Ap icant Date